As a reminder, our COVID-19 Resources webpage includes links to all of our member updates sent from April Payne, as well as the AHCA/NCAL updates. Here are quick links to key updates from this week.

• CARES Act Provider Relief Fund CHOW FAQs 
• COVID-19 FAQs Updated: ACO Section
• Economic Impact Payments for Social Security and SSI Beneficiaries with Representative Payees
• Employee Retention Credit Available for Businesses Affected by COVID-19
  

CARES Act Provider Relief Fund CHOW FAQs 

On May 19, the US Department of Health and Human Services (HHS) posted four FAQs on Change of Ownership (CHOW).

The four CHOW FAQs are:

• Can an organization that sold its only practice or facility under a change in ownership in 2019 and is no longer providing services, accept payment and transfer it to the new owner?  
• If the current taxpayer identification number (TIN) owner has not yet received any payment from the Provider Relief Fund, it may still receive funds in other distributions. Can a provider that purchased a TIN in 2019 accept a Provider Relief Fund payment from a previous owner and complete the attestation for the Terms and Conditions?  
• If, as a result of the sale of a practice/hospital, the TIN that received a general distribution payment is no longer providing health care services as of January 31, 2020, is it required to return the general distribution payment?  
• How does the organization account for these acquisitions when submitting revenue information in the payment portal? 

The UnitedHealth Group CARES Provider Hotline has given guidance that does not align with the FAQs.  AHCA/NCAL has requested clarification on how to address action steps already taken related to CHOWs based on Hotline Guidance as well as a list of other questions to HHS.

COVID-19 FAQs Updated: ACO Section 

On May 15, CMS updated its COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing.

The Accountable Care Organizations (ACO) section included an updated question (pg. 40, question #6) around the length of time a Medicare Shared Savings Program (MSSP) ACO would be responsible for shared losses with the trigger of the Extreme and Uncontrollable Circumstances Policy.

CMS’s response includes an example and explains that ACOs in performance-based risk tracks for 2020 would only be responsible for incurred losses for the time period prior to or after the COVID-19 public health emergency.  The rest of the FAQs are around the MIPS program and beneficiary notifications. With regards to beneficiary notifications CMS continues to allow notifications through email, secure portal, or mail and has relaxed its timely notification policy as long as the beneficiary notification is completed by the end of the performance year. 

Economic Impact Payments for Social Security and SSI Beneficiaries with Representative Payees

The Social Security Administration recently issued an update that beneficiaries who have their regular monthly payments managed for them by another person, called a representative payee, will begin receiving their economic impact payments (EIPs) from the IRS in late May.

It is important to note that under Medicaid rules, a stimulus payment is not counted as income. Therefore, receiving a stimulus payment does not change a resident’s monthly payment (often called a ‘patient pay amount’ or ‘share of cost’). The resident pays the same monthly amount to the nursing facility and keeps the stimulus payment for their own use. In addition, the stimulus payment does not count as a Medicaid resource for 12 months. In other words, for the first year, the payment cannot cause you to have ‘too much’ savings.

More details on these payments can be found in this SSA press release. In addition, you might find of assistance two FAQs from the National Center on Law & Elder Rights entitled, “Nursing Home Residents, Medicaid, and Stimulus Checks: What You Need to Know” and “Medicaid Home and Community-Based Services and Stimulus Checks: What You Need to Know.” Questions on this issue can be directed to COVID19@ahca.org.

Employee Retention Credit Available for Businesses Affected by COVID-19

The IRS recently shared in a COVID-19 tax email update information around the employee retention credit, which is designed to encourage businesses to keep employees on their payroll. The amount of the credit is 50 percent of qualified wages paid up to an annual limit of $10,000, which equals a maximum credit amount of $5,000 for each employee for the year.

Eligible employers are employers who operate a trade or business and has experienced one of these:

• Fully or partially suspended operations because of a government order due to COVID-19
• A significant decline in gross receipts in a calendar quarter when compared to 2019
  

How is the credit figured?

• The amount of the credit is half of qualifying wages paid up to $10,000 for all calendar quarters. The maximum credit for any employee is $5,000 for the year.
• Wages paid between March 12, 2020, and January 1, 2021 are eligible.
• Wages are not limited to cash payments. They also include a portion of employer-provided health care costs.
  

Which wages qualify?

Qualified wages are based on the business’s average number of full-time employees in 2019.

• Small employers, those that had 100 or fewer employees, may receive the credit for wages paid to employees whether or not they are providing services to the employer.
• Large employers, those that had more than 100 employees, may only receive the credit for wages paid to employees for time the employees are not providing services to the employer.

If an employer is eligible due to a full or partial suspension of operations, only wages paid while operations are suspended count as qualified wages.

How do eligible employers get the credit?

Employers must report their qualified wages on their federal employment tax returns, usually Form 941, Employer’s Quarterly Federal Tax Return.

They can reduce their required deposits of payroll taxes withheld from employees’ wages by the amount of the credit. They can also request an advance of the employee retention credit by submitting Form 7200. Eligible employers may use the employee retention credit with other relief such as, payroll tax deferral which may affect deposits and advances. More Information can be found on the Coronavirus page of IRS.gov and here: About Form 7200.